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Questions and Answers About the Early Abortion Pill

In the wake of the Food and Drug Administration's approval of the controversial French abortion pill, RU-486, many people have questions about the new option. The pill, also known as mifepristone, debuted in France in 1988 and has been used by millions of women in 13 countries. We talked to Dr. Bernadine Healy about the abortion pill, its effectiveness and safety.


1. HOW DOES THE ABORTION PILL WORK?


The drug can be used only within 49 days of the beginning of the woman's last menstrual period. The woman takes three mifepristone pills. Two days later, she returns to the doctor to swallow a second drug, misoprostol, that causes uterine contractions to expel the embryo. She then returns for a follow-up visit within two weeks to make sure the abortion is complete.


2. HOW EFFECTIVE IS MIFEPRISTONE?


Studies have shown the drug to be 92% to 95% effective in causing early abortion, by blocking action of a hormone essential for maintaining pregnancy. Without that hormone, progesterone, the uterine lining thins so an embryo cannot remain implanted to grow.


3. ARE THERE ANY SIDE EFFECTS TO THIS PILL?


The pill-induced abortion can be painful, causing bleeding and nausea. Heavy bleeding is a potentially serious side effect, but one the FDA determined is rare. In safety testing of the first 2,100 American women who took mifepristone, four bled enough to need a transfusion.


4. WHO IS ELIGIBLE TO TAKE THIS DRUG?


The key to taking this drug is to take it early on in pregnancy. It should only be used in the earliest days of pregnancy. Women who have ectopic or tubal pregnancies should not take the pill.


5. HOW WILL THE PILL BE DISPENSED?


Before the taking the pill, women will be given special brochures called "MedGuides" explaining who is eligible for the pill-caused abortion and what side effects to expect. However, mifepristone won't be available at the pharmacy. The FDA will allow it to be distributed only to doctors trained to accurately diagnose the duration of the pregnancy and to detect ectopic or tubal pregnancies because those women cannot receive the drug. Also, the FDA restricted mifepristone's use to doctors who can operate in case a surgical abortion is needed to finish the job or in cases of severe bleeding--or to doctors who have made advance arrangements for a surgeon to provide such care to their patients. So, the patient will be heavily monitored by her doctor.


6. WHEN WILL THE PILL BE MADE AVAILABLE IN THE U.S. AND HOW MUCH DOES IT COST?


The manufacturer says the drug should be available in about a month. As for cost, it's expected to be about the same as a surgical abortion.

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